May 12, 2009

STILL A 60-40 NATION:

Forty-five House Democrats in the party’s moderate-to-conservative wing have protested the secretive process by which party leaders in their chamber are developing legislation to remake the health care system.

The lawmakers, members of the fiscally conservative Blue Dog Coalition, said they were “increasingly troubled” by their exclusion from the bill-writing process.

They expressed their concerns in a letter delivered Monday to three House committee chairmen writing the bill, which House leaders hope to pass this summer.

Representative Mike Ross, an Arkansas Democrat who is chairman of the coalition’s health task force, said: “We don’t need a select group of members of Congress or staff members writing this legislation. We don’t want a briefing on the bill after it’s written. We want to help write it.”

Mr. Ross and eight other lawmakers who signed the letter are on the committees responsible for writing the legislation.

They have to run for re-election in the naturally Republican districts that elected them.

[T]he simple fact is this: The degree of national concern about the problems in the system has not been mirrored with equally thoughtful conversation about the spectrum of solutions or the trade-offs required. If the outcome is to be more successful than the last time the nation took on large-scale healthcare reform, it is time to talk in depth about solutions, not just problems. It's time to extend the discussion out of Washington and engage the public about the options for change and what they mean.

A nationwide survey to be released this week by the Stanford Center on Longevity shows that when the issues and tradeoffs are clearly articulated, the voting public understands the issues and raises legitimate concerns. Voters voice great concern about both access and cost. Democratic respondents are relatively more concerned than Republicans about universal access to healthcare; Republicans are relatively more concerned than Democrats about cost. But there is bipartisan concern about both. The voters are correct. To increase access without controlling costs would drive the system to collapse under its own weight. Indeed, it will do so even without greater access.

Why then is health reform so hard? The answers may lie in psychology more than economics. While 62 percent of Americans feel the healthcare system works well for them, 68 percent believe it does not work well for most Americans, a fairly consistent finding in surveys and polls of the past.

More revealing, however, is that while voters believe healthcare reform should be among the top priorities of lawmakers, the majority question whether the advantages of specific potential solutions justify the risks of changing the system. When people feel personally comfortable with the present system even though others are not, change for them is very risky.

The uninsured "crisis" is a media and political creation, not a reality.
Posted by Orrin Judd at May 12, 2009 10:51 AM